Based on radiographs at 1 year follow-up. 74% (45 of 61) of the calcifications decreased, including 28% (17 of 61) which disappeared totally, and 26% (16 of 61) were unchanged. Calcifications with a faint or absent shadow on US proved to be nearly liquid (slurry calcification in 93% (14 of 15) of cases and could be aspirated. Clinical results were excellent in 74% (45 of 61), moderate in 16% (10 of 61) and poor in 10% (6 of 61) of cases. US offers technical advantages over fluoroscopy, and the typical US image of a slurry calcification helps to select the most suitable patients for aspiration treatment. The results are comparable with those using fluoroscopic guidance.

Both US and CT measurements are subject to significant interobserver variability that must be taken into account in the clinical follow-up of small abdominal aortic aneurysms and in screening studies. Neither of these methods can be considered as a 'gold standard'.

Use of this US-guided technique is successful to treat calcific tendinitis in the rotator cuff without the radiation exposure of fluoroscopic guidance.

We studied the findings and value of sonography in the diagnosis of rotator cuff calcifications in comparison to plain radiographs. Sonograms were correlated with plain radiographs in 951 patients. The diagnosis of rotator cuff calcifications was made by ultrasonogra}'hy in 87 and with plain films in 93 of 951 patients. Sonography displayed two additional bursal slurry calcifications not found on plain films. Three types of calcifications were found with ultrasonography: (1) a hyperechoic focus with a welldefined shadow (79%); (2) a hyperechoic focus with a faint shadow {14%); and, (3) a hyperechoic focus C aldfic tendinitis is a common painful condition of the shoulder due to deposition of hydroxyapatite crystals) The deposition is predominantly in the tendons of the rotator cuff, most often at the insertion of the supraspinatus tendon on the tuberosity,2-4 rarely in the other three tendons of the rotator cuff, and sometimes within the tendon or sheath of the long head of the biceps ABBREVIATIONS cr, Computed tomography; MR, Magnetic resonance

A method of shoulder sonography in which lateral and anterior elevation of the arm is used during scanning was demonstrated to be effective in cases of suspected impingement syndrome. The value of the method lies in its ability to demonstrate fluid collection in the subacromial-subdeltoid bursal system, with gradual distention of the bursa and lateral pooling of fluid to the subdeltoid portion while the arm is elevated. In 102 of 381 patients studied, surgical diagnosis was available for correlation. Among this group there were seven false-negative and three false-positive sonographic findings. A comparison of sonographic with surgical findings demonstrated a sensitivity of 81% and a specificity of 95% in stages I-III, and a sensitivity of 71% and a specificity of 96% in early stages I and II of the impingement syndrome. The results of dynamic shoulder sonographic examination with fluoroscopic radiography provide valuable information in patients with suspected early-stage impingement syndrome.